| Regimental number | 6802 |
| Place of birth | Birmingham England |
| Religion | Methodist |
| Occupation | Driver |
| Address | Croydon, South Australia |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, 4Mrs E Norton, Port Road, Croydon, South Australia |
| Enlistment date | 4 September 1916 |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 22nd Reinforcement |
| AWM Embarkation Roll number | 23/27/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A19 Afric on 7 November 1916 |
| Miscellaneous details (Nominal Roll) | missing page |